Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran.
Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Int J Clin Pract. 2022 Feb 18;2022:5397449. doi: 10.1155/2022/5397449. eCollection 2022.
Epidemiological studies have reported inconsistent associations between opium use and cancer risk. We therefore conducted a systematic review and meta-analysis to investigate the relationship between opium use and cancer risk.
We searched PubMed, Scopus, ISI Web of Knowledge, and Google Scholar until February 2021 and references of retrieved relevant articles for observational studies that reported the risk of cancer in relation to opium use. Random-effects models were used to calculate pooled effect sizes (ESs) as well as 95% confidence intervals (CIs) for the association between opium use and cancer risk by considering opium doses and types, duration of consumption, and routes of opium use.
In total, 21 observational articles, with a total sample size of 64,412 individuals and 6,658 cases of cancer, were included in this systematic review and meta-analysis. Ever opium users, compared with never opium users, had 3.53 times greater risk of overall cancer (pooled ES: 3.53, 95% CI: 2.60-4.79, ≤ 0.01). This positive association was also seen for some individual types of cancers except for esophageal and colon cancers. Also, we found that higher opium doses and higher duration of consumption were associated with an increased risk of overall and individual types of cancer. However, the associations between opium doses and the risk of head and neck and larynx cancers were not significant. In terms of the routes of opium use, both opium ingestion and smoking were positively associated with the risk of cancer. Regarding opium types, we found that using teriak, but not shireh, could increase the risk of cancer.
Our findings showed that opium use, particularly in the form of teriak, is a risk factor for cancer.
流行病学研究报告鸦片使用与癌症风险之间的关联不一致。因此，我们进行了系统评价和荟萃分析，以调查鸦片使用与癌症风险之间的关系。
我们检索了 PubMed、Scopus、ISI Web of Knowledge 和 Google Scholar，截至 2021 年 2 月，并检索了相关文章的参考文献，以获取报告鸦片使用与癌症风险相关的观察性研究。使用随机效应模型来计算汇总效应大小（ES）以及 95％置信区间（CI），以考虑鸦片剂量和类型、消耗持续时间和鸦片使用途径。
共有 21 项观察性研究，共有 64412 名个体和 6658 例癌症病例，纳入了本系统评价和荟萃分析。与从未使用过鸦片的人相比，曾经使用过鸦片的人患总体癌症的风险高 3.53 倍（汇总 ES：3.53，95％CI：2.60-4.79，≤0.01）。除了食管癌和结肠癌外，这种正相关也见于一些个别类型的癌症。此外，我们发现较高的鸦片剂量和较长的消耗时间与总体和个别类型癌症的风险增加有关。但是，鸦片剂量与头颈部和喉癌风险之间的关联没有统计学意义。就鸦片使用途径而言，鸦片摄入和吸烟均与癌症风险呈正相关。关于鸦片类型，我们发现使用特丽阿克，但不是希雷，可以增加癌症的风险。
我们的研究结果表明，鸦片使用，特别是特丽阿克的使用，是癌症的一个风险因素。
